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Frontline Reports   |    
Psychiatric Services 2006; doi: 10.1176/appi.ps.57.5.720
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Parents with mental illness have identified loss of custody or loss of contact with their children as a primary barrier to successful treatment and rehabilitation and as a significant source of distress for the entire family. These parents are at high risk of losing contact with their children, often without the benefit of legal representation or judicial process. Lacking adequate representation, and under pressure from child welfare agency workers or relatives, parents may relinquish rights they did not know how to protect. Legal service agencies typically are unable to provide representation, because resources are limited to cases involving domestic violence. Reports from the Volunteer Lawyer's Project and other legal service programs confirm that family law cases that involve parents with mental illness are especially difficult to refer to pro bono attorneys.

Established in 1999, the Clubhouse Family Legal Support Project (CFLSP) has demonstrated that integrating legal services with parental supports can have a positive impact on the preservation of family relationships for some of the most vulnerable children and stigmatized parents. The CFLSP is a collaborative project co-led by Employment Options, Inc. (Options), a clubhouse in Marlborough, Massachusetts, and the Mental Health Legal Advisors Committee (MHLAC) in Boston. The Options Clubhouse provides 24-hour support, parenting education, home visits, parent support groups, visitation supervision, and service coordination and collaborates with the Massachusetts Department of Social Services (DSS) and the Massachusetts Department of Mental Health (DMH). The Mental Health Legal Advisors Committee, a committee of the Massachusetts Supreme Judicial Court, provides direct representation to low-income adults and children with mental illness. In addition, the agency engages in systemic advocacy through education and training of clients, attorneys, and judges and through litigation and legislative efforts.

The CFLSP provides legal advice and referrals, community supports, training and education, and pro bono representation to low-income parents with mental illness and advice and resource information to other attorneys who represent them. The project receives referrals from DSS and DMH, legal services agencies, and directly from judges and court staff. Clubhouse staff can contact the project on behalf of their members, or members can call directly to discuss their family-related legal issues. CFLSP clients are not required to be clubhouse members but are encouraged to seek clubhouse supports.

Funding from the Massachusetts Bar Foundation and DMH supports the work of one full-time CFLSP attorney. The executive director of the MHLAC supervises the legal components of the project, and the executive director of Options coordinates the provision of parenting supports through existing Options services. Students from local law schools receive valuable practical experience working either for clinical credit or as summer interns with CFLSP clients. The project's attorney is actively involved with the Massachusetts Bar Association, the Boston Bar Association, the Family Law Task Force, the Parents With Mental Illness Strategic Planning Committee, and the Volunteer Lawyers Project's Senior Partners for Justice pro bono program, as part of a collaborative approach to representing clients with mental illness in family law cases. The CFLSP also has an advisory board of clinicians, attorneys, a parent, and others with expertise in parenting and mental illness.

The Clubhouse Project has demonstrated significant success for its clients, improving their access to legal assistance as well as their case outcomes. Since the program began, more than 100 parents with mental illness have benefited from direct legal representation, with the staff attorney representing about 23 parent clients per year. Attorneys from the CFLSP and MHLAC have fielded a total of 420 intake telephone calls in the past four years, providing individuals with information about their legal rights as parents and about additional resources available to them. The CFLSP has also provided training and presentations on parenting and mental illness to almost 400 attorneys, judges, and mental health clinicians in the past four years. Since 2004 two-thirds of the parents who received direct representation from the project's attorney achieved their goal of increased contact with their children. Among the greatest challenges the CFLSP and its clients continue to face is the overwhelming stigma associated with individuals who have mental illness and their ability to parent.

The CFLSP has gained national attention. In its publication Keeping Kids Out of the System, the American Bar Association Center on Children and the Law highlighted CFLSP as an exemplary creative legal practice. The project's work has been widely disseminated, and staff members participate in regional and national conferences, discussing the innovation of the Clubhouse Project.

The authors are affiliated with the Clubhouse Family Legal Support Project, 399 Washington Street, 4th Floor, Boston, Massachusetts 02108 (e-mail, knemens@mhlac.org). Dr. Nicholson is also with the department of psychiatry at the University of Massachusetts Medical School in Worcester.




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